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NPI Code Detail

MEDICARE: MRS. DRESHELLIA MONQUELLIA HARGRAVE NP

MEDICARE: MRS. DRESHELLIA MONQUELLIA HARGRAVE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP07682LA
2363LF0000XFamily Nurse PractitionerAP07682LA

General Provider Information

NPI Number : 1235552548
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DRESHELLIA MONQUELLIA HARGRAVE NP
Provider Business Mailing Address
First Line : 17000 MEDICAL CENTER DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-3246
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5750 JOHNSTON ST STE 205
Second Line :
City : LAFAYETTE
State : LA
Zip : 70503-5345
Country : US
Telephone Number : 337-580-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2014
Last Update Date : 05/31/2026

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